Long-Acting Reversible Contraceptives
What are LARCs?
Long-acting reversible contraceptives (LARCs)
are a group of methods that:
• provide very effective contraception
• are long acting
• don’t require you to do anything to prevent
pregnancy every day or every time that you
have sex
• are reversible when stopped
The “fit and forget” LARCs include intrauterine
devices (IUDs) and hormonal implants. These
methods are all more than 99% effective. While this
means they are just as effective as permanent
sterilisation, there is a rapid return to usual fertility as
soon as LARCs are removed.
LARCs are generally inexpensive over time, although
there may be upfront costs with their purchase and
initial insertion. Other than the copper IUD, they are
listed on the Pharmaceutical Benefits Scheme (PBS)
in Australia which makes the cost similar to or less
than a short supply of oral contraceptive pills.
Thinking about using a LARC?
There are many myths about contraceptive methods,
including who is or isn’t suitable to use different types,
so it is important to find out the facts.
LARCs can be used by most women of any age
including those who:
• can’t use contraceptives containing the hormone
oestrogen due to health problems
• experience side effects with oestrogen, such as
nausea or breast tenderness
• have migraines
• are heavy smokers
• have never had a baby
• are breastfeeding or have recently had a baby
• have recently had an abortion
• are overweight
• have diabetes
• have epilepsy
• are HIV-positive
• have inflammatory bowel disease
Choosing a LARC?
Prior to commencing a LARC there will be an
assessment of your health and suitability for different
methods. The practitioner should discuss benefits
and any side effects or disadvantages of the different
options and encourage you to ask questions to help
you decide which method you prefer.
Brief information about the LARC methods available
in Australia is provided below. More detailed
information on these methods is available on the
websites of State and Territory Family Planning
organisations.
LARC methods include implants, IUDs,
and injections
Progestogen implants: ImplanonNXT®
The implant is inserted
directly under the skin, on
the inner arm above the
elbow, where it continuously
releases a low dose of a
progestogen hormone into
the blood stream over a 3
year timeframe.
The implant works by preventing ovulation and is
99.9% effective. It is immediately reversible on
removal.
Implant insertion and removal involves a small
procedure, with local anaesthetic, by a doctor or
nurse trained in this procedure. Most GPs will be able
to provide this service.
Implants:
• are suitable for women of any age if they have
started menstruating
• can be used in most women, even if they have
any significant health issues
• can be inserted immediately after a pregnancy
• will change a woman’s usual bleeding pattern
– for some women this will mean little or no
bleeding at all but about 1 in 5 women have
irregular or persistent bleeding
Intrauterine devices: Contraceptive injections: Depot
medroxyprogesterone
IUD insertion and removal is performed by a doctor or acetate (DMPA)
nurse who has been trained in this procedure.
Devices need to be replaced every 5-10 years DMPA is given as an
depending on their type. IUDs can be removed easily intramuscular injection every
at any time by a health professional and are 12 weeks.
immediately reversible on removal.
DMPA works by preventing
Both types of IUDs: ovulation and is 99.8%
• are suitable for women of any age effective with perfect use.
• can be used by most women, even if they have However, DMPA is less effective (94%) than the other
any significant health issues LARC methods in typical use because sometimes
• require an insertion procedure which for some regular injections are not given on time.
women may be uncomfortable For continuing protection it is important to have
follow-up injections every 12 weeks. DMPA requires a
The hormonal IUD (Mirena®) is a T-shaped plastic prescription by a doctor.
device fitted inside the
uterus, which slowly For some women return of normal fertility and periods
releases a progestogen can take quite a few months after stopping DMPA.
hormone into the womb However, fertility is not permanently affected.
over a 5 year timeframe.
It thickens the mucus in The contraceptive injection DMPA:
the cervix; thins the lining • can be used by most women, even if they have
of the uterus and effects the implantation of the egg. any significant health issues
It is 99.8% effective. • requires a visit to a clinic for a repeat injection
every 12 weeks
The hormonal IUDs: • will change a woman’s usual bleeding pattern
• reduce the amount of bleeding with periods – for most women this will mean little or no
and can be used to manage heavy menstrual bleeding at all, particularly with ongoing use
bleeding • may result in a slower return to usual fertility
• may cause irregular bleeding and spotting in when stopped than the other LARC methods
first few months after insertion • if side effects are experienced, the method
• can be left in until after menopause, if inserted cannot be reversed until the injection effects
after the age of 45 have worn off
The Copper IUD is a small device made from plastic
and copper that is fitted Where are LARCs available?
inside the uterus.
It works by blocking sperm Implants and DMPAs are available from GPs and
from reaching the egg and Family Planning clinics. IUDs are inserted at Family
any fertilised egg from Planning clinics, gynaecologists and some GPs.
sticking to the wall of the
womb (uterus) and is 99.2%
effective.

Copper IUDs:
• may increase the amount of bleeding with ©Sexual Health & Family Planning Australia
Disclaimer
usual periods Sexual Health & Family Planning Australia has taken every care
• can be left in until after menopause if inserted to ensure that the information contained in this publication is
after age 40 accurate and up-to-date at the time of being published. As
information and knowledge is constantly changing, readers are
strongly advised to confirm that the information complies with
present research, legislation and policy guidelines. FPQ
accepts no responsibility for difficulties that may arise as a
result of an individual acting on this information and any
recommendations it contains.
Version 1/May 13
This resource is funded by the Department of Health & Ageing,
Australian Government.